What do the new CDC mask guidelines mean?
If you're fully vaccinated, federal health officials now say that you can take your mask off in most places—even indoors.
But the question remains whether the new guidelines will inspire more people to get fully vaccinated or instead send an unintended message that the war against the COVID-19 virus is won.
"The updated guidelines from the CDC is really positive news. It should offer us a lot of hope," says Neil Maniar, professor of public health practice at Northeastern. "It should be an added incentive to make sure that folks get vaccinated."
The updated guidelines from the Centers for Disease Control and Prevention are just guidelines. State and local rules still apply. And the new guidelines are only for people who are fully vaccinated, which means two weeks have passed since your second shot of the two-dose vaccines or since you received a single-dose vaccine. The changed guidelines aren't for everywhere, either. The CDC still says that everyone should continue to wear masks on public transportation, including planes, trains, and buses.
"It is about dangling the carrot, it's about providing that incentive," Maniar says of the CDC's announcement, which was emphasized by a mask-less President Biden in an address to the nation Thursday. "We know that these vaccines are effective. We know that they're safe. And that's a really, really important thing. I think that should be a real incentive for folks to get their vaccination because that will get us to that point that we all want to be at where we can say this pandemic is now behind us. We're not at that point yet, but we have the potential to get there."
But whether or not that is the message that comes through to all Americans is an open question.
"The devil is always in how things play out. How does it actually play out in the real world where things are messy, where people are complicated, where different communities have different norms and cultures and hear messages differently?" says Wendy Parmet, Matthews Distinguished Professor of Law at Northeastern. "Is the message [people will hear] going to be 'get vaccinated," or is the message going to be, 'see, now I can just live my life as if there was no pandemic and no one's going to know." We are not a society that hears one message."
It's possible to consider people who are medically able to get vaccinated but have not yet gotten any shots in three groups, says Parmet, who also leads the Center for Health Policy and Law. There's a group of people who want to get vaccinated but haven't been able to take time off work because they can't afford to or for other financial reasons, or who just don't have all the information about how to get vaccinated. Then there's a group that's hesitant but not outright against getting vaccinated. The third group is completely against getting vaccinated and there will likely be no convincing them, she says.
It's the middle group—the hesitant group—that the CDC might be able to entice by removing mask guidelines for vaccinated people, Parmet says. "Certainly there are people who have thought, 'why bother getting a vaccine if I'm still going to need to wear a mask,'" she says.
But, Parmet says, there also might be some "free-riders." She says, "As deaths and hospitalizations decline, there's a tendency to think, 'it's no big deal and I'm safe because everyone else is getting the vaccine.'"
The CDC's new guidelines for vaccinated individuals are backed by tentatively hopeful numbers, says Maniar, who is also associate chair of the department of health sciences and director of the master of public health program at Northeastern. According to the CDC, 35.8 percent of the U.S. population is fully vaccinated, and 46.6 percent has gotten at least one dose. In some states, those numbers are even higher. In Massachusetts, for example, 44.8 percent of the population is fully vaccinated, and nearly 60 percent has gotten at least one shot.
"The hope is that we'll continue to see those [vaccination] numbers go up," Maniar says. "Over the past month, we had a big expansion in terms of individuals who are now eligible to get the vaccine," he says, between all adults in the U.S. becoming eligible on April 19 and the CDC approving the Pfizer-BioNTech vaccine for use in adolescents ages 12 to 15 on Wednesday. "We're putting the pieces of this puzzle together."
Reaching the herd immunity thresholds targeted by many public health officials of 70 or 80 percent—or more—of a population having immunity against the virus might be too lofty of a goal, Maniar says, "given what we know about vaccine hesitancy. But I think we are getting to a point where we're on a trajectory in certain areas … that we are likely going to hit it, maybe that minimum threshold. If we can get to 70 percent of individuals who are fully vaccinated here in Massachusetts, that is an incredible barrier against the virus."
Furthermore, cases across the U.S. have been decreasing notably and are projected to continue to decline further as summer dawns. On top of that, says Brandon Dionne, assistant clinical professor of pharmacy and health systems sciences at Northeastern, the vaccines seem to be even more effective at preventing infection in the real world than they were determined to be during clinical trials. The CDC has received reports of fewer than 10,000 breakthrough cases in fully vaccinated individuals and more than 118 million people in the U.S. have been fully vaccinated so far.
Despite the decrease in cases and increase in vaccination rates, Maniar says, "we can't let our guard down" and it will be important to monitor case numbers following the change in the CDC guidelines. "The one thing that we have absolutely learned over the past 15 months, if not longer, is that the moment we let our guard completely down, we've opened the door to complications."
One concern about how the new mask and physical distancing guidelines will play out comes from the lack of a system in the U.S. to keep track of who is vaccinated and who is not when entering a public space.
"The guidance is for people who are vaccinated," Parmet says. "But the problem is that, you know, is the grocery store going to figure out who is vaccinated or who's unvaccinated? Is the restaurant going to figure it out?"
It's not that coming up with a government system to track the movement of vaccinated and unvaccinated individuals in public spaces is technologically impossible, she adds. Rather, it would likely be seen as too much of an invasion of privacy in American culture. So instead, she says, the onus on figuring out how to implement these new guidelines gets passed down to states, local authorities, and even business owners themselves.
Those lingering questions are likely one reason why state governors—including Massachusetts Gov. Charlie Baker—have not all adjusted their mask mandates in accordance with the CDC's new guidelines yet. Another reason is likely that some communities are still seeing higher numbers of positive cases of COVID-19.
"The new CDC guidelines open the door for states and communities to relax existing COVID restrictions," Maniar says. "However, they do not require them to do so. Therefore, the implementation of the guidelines may take a bit longer for some communities compared to others based on the level of readiness to relax existing regulations."